Your Feet Disorders Database

Overview Pain in arch of foot, a very common problem for millions of people worldwide who are suffering from this ailment every single day. Whether it's arch pain, heel pain, bunion pain, big toe pain, little toe pain or anything else in between, sore feet are no fun! It's no denying that if your feet aren't right, you feel out of sorts. In this article you will discover the possible causes of the pain in the arches of your feet and common treatments and solutions. Often linked with heel pain, pain in the arch of the foot is very common, particularly in those that spend a lot of time on their feet and those that play sports regularly.

Causes The arch of the foot is a very complex structure, consisting of multiple bones and ligaments. Most causes of arch pain are related to the anatomy of the arch and the types of physical activity that you perform. For example, a classic set up for arch pain is people who engage in lots of high impact exercise (such as running) while wearing a type of athletic shoe that does not properly support their type of foot arch.

Symptoms The majority of children and adults with flexible flatfeet never have symptoms. However, their toes may tend to point outward as they walk, a condition called out-toeing. A person who develops symptoms usually complains of tired, aching feet, especially after prolonged standing or walking. Symptoms of rigid flatfoot vary depending on the cause of the foot problem.

Diagnosis A patient is asked to step with full body weight on the symptomatic foot, keeping the unaffected foot off the ground. The patient is then instructed to "raise up on the tip toes" of the affected foot. If the posterior tibial tendon has been attenuated or ruptured, the patient will be unable to lift the heel off the floor and rise onto the toes. In less severe cases, the patient will be able to rise on the toes, but the heel will not be noted to invert as it normally does when we rise onto the toes. X-rays can be helpful but are not diagnostic of the adult acquired flatfoot. Both feet, the symptomatic and asymptomatic - will demonstrate a flatfoot deformity on x-ray. Careful observation may show a greater severity of deformity on the affected side.

Non Surgical Treatment There are many different causes of and treatments for flat foot. The most important part of treatment is determining the exact flat foot type on an individual basis, and doing so early on. The main objective is to become educated on the potential problems, so that you can stop them before they start. Conservative treatment is often successful if initiated early. The old adage "a stitch in time saves nine" definitely applies to the human body, hopefully more figuratively than literally. Do not ignore what your common sense and your body are telling you. Yes, you can live without an arch, but never neglect a symptomatic foot. If you neglect your feet, they will make you pay with every literal step you take.

Surgical Treatment There are two types of bone procedure for flat feet, those where bone cuts and bone grafts are used to alter the alignment by avoiding any joint structures, or joint invasive procedures (called fusions or arthrodeses) that remove a joint to reshape the foot. With joint fusion procedures, there are those procedures that involve non-essential joints of the foot versus those that involve essential joints. All bone procedures have their place in flat foot surgery, and Dr. Blitz carefully evaluates each foot to preserve as much motion and function while obtaining proper and adequate alignment. In many cases a flat foot reconstruction involves both soft tissue procedures and bone procedures to rebuild and restore the arch. There are several joints in the arch of the foot that can collapse - and these joints are non-essential joints of the foot. This does not mean that they do not have a purpose, but rather become inefficient is providing a stable platform for function. As such, locking these non-essential non-functioning joints into place is commonly recommended. These joints are fused together with screws and/or plates. A heel bone that is no longer in proper position and pushed outwards away from the foot can be corrected with a bone cut and realignment procedure, so long as the displacement is not too significant. A benefit of this surgery is that it keeps the back portion of the foot mobile, and helps the surrounding tendons work for efficiently in maintaining the arch. In certain flat feet, the foot is deviated outwards and away from the midline of the body. Sometimes, this is due to the outer portion of the foot being shorter than the inner portion. Here bone graft can be added to the outer edge of the foot to lengthen the foot to swing the foot over into a corrected position. This procedure is most commonly performed in children and young adults. A bone graft is inserted into the top part of the arch to realign a component of the flat foot, medically known as forefoot varus or medial column elevatus. The back part of the foot (called the rearfoot complex) can be the cause (or source) of the flat foot or the simply affected by the flat foot foot. In simple terms, the back part of the foot can be made to flatten out due to arch problems - and vica versa for that matter. Dr. Blitz specifically identifies the cause of the flat foot as this will determine the best treatment plan, as each flat foot needs to be evaluated individually. The rearfoot is made up of three joints, and depending on the extent and most importantly the rigidity of these joints, they may require fusion to restore alignment. When all three joints require fusion - this call is a triple arthrodesis. For completeness, isolated fusion of any of the three joints can be performed (such as subtalar joint arthrodesis, talonavicular arthrodesis, and calcaneaocuboid joint arthrodesis). The medical decision making for isolated fusions is beyond the scope this article, but Dr. Blitz tries to avoid any rearfoot fusion for flexible feet because these are joints are essential joints of the foot, especially in younger people. Those in severe cases, it may be advantageous to provide re-alignment.

Stretching Exercises Calf Stretching in Bed. As you may already know, the first few steps out of bed in the morning can be the worst of the day. Those first few steps can be enough to reaggravate your condition putting you into a cycle of inflammation and pain. The best way to help break that cycle is to stretch your calf before taking those first steps in the morning. When the muscles in your calf are tight, they pull on the heel bone, making your plantar fascia very taut and prone to injury. To help loosen those muscles, take a towel or belt and loop it around the ball of your foot. Keeping your leg straight, gently pull towards your body until you feel a stretch in the lower part of your leg. Hold that for 30 seconds and repeat up to 5 times before taking your first step out of bed. Plantar Fascia Stretching. Loosening up the tissues that are irritated probably makes sense to you, but you may not know how to do so. Luckily, there?s a very simple way. All you have to do is pull your toes up with your hand until you feel a stretch along the ball of your foot. You may feel the stretch anywhere from the ball of your foot to your heel. Holding this position for 30 seconds a few times can make a world of difference in your pain levels. Calf Stretching. I know, it probably seems like overkill, but stretching out the muscles in the lower leg is an integral step to recovery. There are two main muscles in the lower leg that attach to the heel, so we?ll work on stretching them both out. Stand against a wall and slide one leg back, pushing the heel down towards the floor (first picture). When you feel a stretch in the lower part of your leg, hold it for 30 seconds. After those 30 seconds are up, bend your knees until a deeper stretch is felt a bit lower in the leg (second photo). Again, hold this stretch for 30 seconds and repeat this until you?ve done it 3 times on each leg. Who doesn?t love a good massage? I suppose you could pay for someone to rub out the tissues in the bottom of your foot, but if you?re looking for a cheaper alternative, look no further than the humble tennis ball. Placing a tennis ball on the ground and gently rolling it under foot for a few minutes can help loosen up your plantar fascia, making it much less likely to become irritated. Put enough pressure on the ball to get a deep massage. You may feel some soreness, but back off if you feel any pain.Tennis Ball Massage While using the tennis ball is great for keeping things loose, sometimes it?s worth doing some icing at the same time for some inflammation control. Freezing a water bottle and rolling it under your foot for 10 minutes at the end of the day can be a very effective way to keep inflammation in check while staying loose. It might not be the most comfortable thing in the world, but ?Brrr? is better than ?Ouch? any day. One thing to keep in mind is that while these tips have been proven to work, they?re not an instant fix. It can take a few weeks of consistency with them before your pain levels begin to change. If you?re not seeing any improvement after making an honest effort, it may be time to look into some different treatment methods with your doctor such as formal PT, orthotics, a weight-loss plan, or others.